Virtual Classrooms Without Borders: Global Online Project Transforms Occupational Therapy Education

What happens when occupational therapy students from eight countries across three continents sit down together in a virtual room and simply talk? According to a new mixed-methods study published in the Scandinavian Journal of Occupational Therapy, the answer is a striking transformation in professional confidence, cultural awareness, and interpersonal skill. The research examined the International Discussions in Occupational Therapy project, known as i-DOT, an annual online collaborative learning initiative that brings together students from institutions in Europe, Africa, and Asia for a month of structured virtual discussions. The findings suggest that meaningful international education no longer requires expensive travel, and that a laptop and a reliable connection may be enough to deliver some of the most formative experiences of a health professional’s training.

The i-DOT project originated at Artevelde University of Applied Sciences in Ghent, Belgium, in 2018, and grew rapidly during the COVID-19 pandemic, when the sudden adoption of information and communication technology in higher education opened the door to nine collaborating institutions. The format is deliberately lightweight: over roughly one month, students participate in two to three discussion sessions on occupational therapy topics such as occupational deprivation and disruption among older adults. They share societal and professional perspectives from their home countries with peers abroad and with international organizations, coordinating their virtual exchanges independently. Crucially, each institution retains full autonomy, deciding whether participation is compulsory or voluntary, whether academic output is required, and whether students are assessed, while shared resources such as guiding questions keep the experience coherent across groups.

The study employed a convergent mixed-methods design, collecting quantitative and qualitative data in parallel and merging them for comparison. In the quantitative phase, 139 occupational therapy students completed a 54-question electronic survey, translated into English and German and piloted with 13 participants from six countries, yielding a response rate of 69.5 percent. The survey covered demographics, general experience, academic and professional development, personal and social development, cultural awareness, and overall experience, using Likert scales, single- and multiple-response formats, and open-ended questions. In the qualitative phase, three student focus groups involving ten students, one focus group with three educators, and two individual educator interviews were recorded, transcribed, and analysed by at least three researchers each using an adapted hybrid thematic analysis based on Braun and Clarke’s six-step coding process.

The headline result is unambiguous: 77.7 percent of surveyed students agreed they benefited from the project. The largest gains appeared in social and interpersonal skills, followed closely by accelerated professional development. Most strikingly, 75.54 percent of participants believed their learning experience was richer than it would have been had they interacted only with peers from their own country. Students reported discovering entirely new practice domains, with one participant from Croatia marveling that school-based occupational therapy, absent in her home country, was ‘a whole new level of excitement’ to learn about. Others compared degree structures, classroom practices, and intervention strategies across borders, gaining a comparative understanding of their own profession that no domestic curriculum could easily replicate.

The project also appeared to shape professional identity. Some 67.63 percent of students agreed they developed their identity as future occupational therapists, and 79.85 percent were convinced the skills learned would benefit them in future working environments. Participants described deepened awareness of diversity that extended well beyond nationality, encompassing lifestyle, cultural, political, and religious differences, with one student noting that comparing cultures, religions, and practices became ‘the highlight of all of our discussions.’ The researchers argue this exposure helps students conceptualize occupation in the context of culture and occupational justice, capabilities aligned with the World Federation of Occupational Therapists’ minimum standards, which call for curricula grounded in local contexts but informed by global perspectives.

Personal and social growth was equally prominent. Most students, 83.45 percent, felt more confident communicating with new people, 81.29 percent reported improved active listening, and 66.19 percent described themselves as more confident overall. Communication skills were cited by 91.37 percent of participants, and organizational skills by 54.68 percent. The qualitative data added texture: students spoke of stepping out of their comfort zones, connecting on a deeper level, helping each other with assignments, and maintaining friendships long after the project ended. One participant described her i-DOT partners as her first two friends outside her own country, a detail that captures the human dimension behind the statistics.

Participation was not without friction. The study identified two broad categories of challenges: logistical and participant-related. Logistical barriers included busy academic schedules, cited by 43.17 percent of students, poor internet connectivity at 39.57 percent, technological difficulties at 25.18 percent, different time zones at 13.67 percent, and loadshedding by a national power utility at 7.19 percent. Yet the qualitative findings complicated the picture: students found time zones easier to navigate than anticipated and laughed off connection problems rather than letting them derail discussions. Language posed the greatest participant-related challenge, since the project ran in English, which was not a first or second language for some students, but only 43.88 percent reported it as a difficulty. One educator observed that students feared the language barrier most before starting, only to realize during interviews that it was far less of a problem than anticipated.

The study also illuminated what made participation work. Student-led facilitators included planning ahead, using tactics to boost communication, and deploying translation software, with one student describing how partners would pause meetings to consult Google Translate. Digital tools and virtual platforms created what participants called a safe setting, a less confrontational environment in which, as one put it, the screen between them allowed freer speech. The freedom to use multiple platforms helped too: some groups moved to WhatsApp voice messages, finding it easier to record speech than to type in a second language. Notably, 90.69 percent of students agreed they had sufficient technological skills, likely a legacy of pandemic-era ICT adoption, and 45.32 percent said they were internally motivated to participate despite receiving no academic marks. Statistical testing found motivation was not associated with grading, suggesting the experience carried intrinsic value.

Structural features of the project mattered as well. Educators reported that providing guiding questions in advance helped students plan, prepare, and feel engaged, while preparation led by educators, peer mentorship from former participants, and the project’s manageable one-month duration with just two to three discussions all supported engagement. Contrary to earlier research suggesting that mixing students from different academic years hampers interaction, only 2.2 percent of participants in this study cited year of study as a negative factor, and for most it functioned as an enabler. Students recommended greater engagement with educators during and after the project and better alignment of preparatory activities across institutions, offering a practical roadmap for future iterations.

The implications extend well beyond occupational therapy. The authors argue that short-term online collaborative learning engagements of just two to three hours can yield substantial outcomes, making such initiatives feasible within existing curricula across disciplines. By removing financial and travel barriers, the online format promotes equity, allowing students to access international experiences and practice areas unavailable in their home countries, which in turn contributes to professional identity formation and advocacy potential. As health systems worldwide grapple with increasingly diverse populations and a growing demand for culturally competent clinicians, the i-DOT model offers a flexible, low-cost template: preserve institutional autonomy, standardize only what is necessary, trust students to coordinate their own exchanges, and let a month of honest cross-cultural conversation do the rest. The study’s authors acknowledge limitations, including unequal representation across countries and the possibility that participants were inherently motivated, and they recommend pretest-posttest designs in future research. Even so, the evidence points to a compelling conclusion: transformative international education can now happen at home, one virtual discussion at a time.

Subject of Research: International online collaborative learning and its benefits and barriers for occupational therapy students

Article Title: An international online collaborative learning project for occupational therapy students: A mixed-methods study

Article References: An international online collaborative learning project for occupational therapy students: A mixed-methods study. (n.d.). https://doi.org/10.1080/11038128.2025.2599034

Image Credits: AI Generated

DOI: 10.1080/11038128.2025.2599034

Keywords: occupational therapy, online collaborative learning, internationalization at home, health education, virtual exchange, cultural awareness, professional identity, higher education, mixed methods, student engagement, intercultural learning, i-DOT project